Open AccessSymptoms and health‐related quality of life 5 years after catheter ablation of atrial fibrillation
Author(s) -
Walfridsson Ulla,
Hassel Jönsson Anders,
Karlsson Lars O.,
Liuba Ioan,
Almroth Henrik,
Sandgren Emma,
Walfridsson Håkan,
Charitakis Emmanouil
Publication year - 2022
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23752
Subject(s) - medicine , atrial fibrillation , quality of life (healthcare) , hazard ratio , catheter ablation , cohort , cohort study , atrial tachycardia , heart failure , prospective cohort study , physical therapy , cardiology , confidence interval , nursing
Objectives To investigate the effect of catheter ablation (CA) on symptoms and health‐related quality of life (HRQoL) after 5 years, and analyze predictors of recurrence of symptoms. Background The primary indication for CA of atrial fibrillation (AF) is to reduce symptoms and improve HRQoL where long‐term follow‐up are sparse. Methods In this observational, long‐term, single‐center study, patients were recruited from Linköping University Hospital, Sweden. They were aged ≥18 years and had been referred for CA from November 2011 until June 2019. Arrhythmia‐specific symptoms and HRQoL were assessed by patient‐reported outcome measures (PROMs) with the Arrhythmia‐Specific questionnaire in Tachycardia and Arrhythmia (ASTA). Results In the study were 1521 patients, 69% men, mean age 62 years. At baseline, 87% of the patients and at the 5‐year follow‐up 80% of those eligible filled out the ASTA questionnaire. At follow‐up, 50% reported freedom from symptoms, 18% had >50% symptom reduction, 14% had a minor reduction, while 18% reported no effect or a worsening of symptoms. Factors predicting symptoms were female gender (hazard ratio [HR]: 1.8; 1.2–2.8), body mass index ≥ 35 (HR: 3.9; 1.6–9.8), and ischemic heart disease (IHD) (HR: 2.6; 1.2–5.9). After 5 years, breathlessness during activity, weakness/fatigue, and tiredness were still the most common symptoms; regarding HRQoL they were impaired physical ability and deteriorated life situation. Conclusions and Clinical Implications This clinical cohort of patients with AF evaluated through PROMs showed that CA had long‐lasting effects on symptoms and HRQoL and that the use of PROMs in clinical routines was feasible. Factors predicting symptoms after CA were female gender, IHD, and obesity, an important reminder to encourage lifestyle management.